The Health and Wellbeing Board of Hillingdon Council met on Wednesday 17 June 2026 to discuss the integrated health and wellbeing performance report, the joint health and wellbeing strategy update, the Better Care Fund, and the occupational therapy service. Key decisions included noting the outcomes of the public consultation on the joint health and wellbeing strategy and approving the 2026/27 Better Care Fund plan.

Integrated Health and Wellbeing Performance Report and Service Update

Sean Bidewell, representing the West and North London Integrated Care Board (ICB), presented a comprehensive report on the integrated health and wellbeing performance and service updates. The report highlighted tangible improvements in several areas, including hospital flow and discharge, mental health crisis care, and care delivered closer to home. For instance, the Lighthouse service for mental health crisis care had seen a doubling in patient numbers, with the majority being supported back home within 24 hours. Mobile diagnostic services were also introduced, allowing tests like X-rays to be carried out in people's homes, particularly benefiting frail and housebound residents.

Despite these improvements, challenges remain. Hospital demand, particularly A&E attendances, continued to be above target, with an 8% increase in activity observed in April. The length of stay in hospitals for some patients also remained longer than planned. Work is ongoing to address these issues, including an audit of patients attending A&E to understand the reasons and develop targeted interventions.

The report also detailed year-on-year reviews, showing significant increases in primary care appointments and a reduction in urgent and emergency care attendances. Integrated Neighbourhood Teams (INTs) are now operational across all localities, bringing together GPs, community services, mental health, and social care. The Best Start in Life programme has seen significant improvements, including a reduction in the neurodevelopmental waitlist and expansion of mental health support teams in schools.

Gary Collier, the Council's Health and Social Care Integration Manager, provided further details on the end-of-year reporting template submitted to NHS England. While the target for permanent admissions to care homes was met, the targets for emergency admissions for those aged 65+ and discharge delays were not fully achieved. Financially, there was a £1.9 million underspend against the disabled facilities budget.

Discussions during the meeting focused on understanding the reasons behind increased A&E attendances and exploring how to better engage residents with early intervention services. Dr Alan McGlennan, a member of the board, noted that while Hillingdon Hospital was performing well compared to other trusts, the increase in footfall across North West London was a concern that the ICB was actively addressing. Councillor Susan O'Brien, Cabinet Member for Adults, Children, Health & Care, sought confirmation that patients signposted from emergency services were not repeatedly returning due to a lack of appropriate care.

Sharon Stoltz, Director of Public Health, highlighted the need for a collective surge response when hospitals are under pressure and suggested placing more support near the front door of hospitals to facilitate diversion. Sandra Taylor, Corporate Director of Adult Social Care and Health, commented on the importance of prevention services starting earlier in life and the need for robust evaluation data.

Joint Health and Wellbeing Board Strategy Update

Gary Collier presented an update on the draft Joint Health and Wellbeing Strategy 2026-2031, which sets out the direction for supporting residents' health and wellbeing. The consultation process, involving residents and professionals, revealed overwhelmingly supportive feedback. Key themes from residents included concerns about joined-up care and communication issues, inconsistent access to timely help (particularly for urgent care and mental health), digital exclusion, and quality and accountability concerns regarding private providers. Residents also expressed strong support for local hubs but raised questions about accessibility, opening times, and transport.

Proposed amendments to the strategy include changing the Best Start in Life heading to Start Well to align with the World Health Organisation's life-course model, and adding a target to achieve 'UNICEF UK Baby Friendly' accreditation status. The Board was asked to note the consultation outcomes, approve the proposed amendments, and delegate authority to the Corporate Director of Adult Social Care and Health to approve the final strategy.

Keith Spencer, Managing Director of Hillingdon Health and Care Partners, noted that the feedback was consistent with previous concerns raised and highlighted a tension between building services around residents and meeting staff needs. Samreen Nawshin, Operations Manager at Healthwatch Hillingdon, echoed the findings regarding residents having to repeat their stories and the gap in joined-up services.

The Board agreed to note the consultation outcomes, approve the proposed amendments, and delegate authority for the final approval of the strategy.

2026/27 Better Care Fund Update

Gary Collier provided an update on the Better Care Fund (BCF) plan for 2026/27. The total value of the plan has increased to £76.3 million, with a 4.4% increase in the NHS minimum contribution to adult social care. Key drivers influencing the plan include the full-year effect of savings from a previous BCF review, the impact of inflation, and the priority of shifting care from hospitals to the community (left shift ).

The plan focuses on priorities such as developing Integrated Neighbourhood Teams (INTs), continuing the hospital-to-community transformation, and implementing a borough-wide Reactive Care Service. National metrics for emergency admissions, discharge delays, and permanent admissions to care homes remain the same, with targets set to be achievable. The report also included a summary of the equality and human rights impact assessment, identifying actions to address potential access inequalities and support for carers.

The Board approved the 2026/27 Better Care Fund Plan, agreed to delegate authority for amendments, and noted the actions arising from the Equality and Human Rights Assessment.

Occupational Therapy Service Update

Gary Binstead provided an update on the Occupational Therapy (OT) service for children with Special Educational Needs and Disabilities (SEND). He reported that despite national shortages of OTs, Central and North West London NHS Foundation Trust (CNWL) had fully recruited to its OT service by the end of June 2026. All young people had received their due contacts, and plans were in place to review and catch up on any missed sessions.

Concerns were raised about the sustainability of the service financially, but it was confirmed that conversations were ongoing with CNWL regarding demand and capacity. The new white paper on SEND reforms was also noted as potentially having an impact. Julie Kelly, Corporate Director of Children's Services, highlighted that the increase in demand for EHCPs had been significant and that efforts were being made to ensure children received the necessary services. Shannon Stoltz, Consultant in Public Health, mentioned the need for a SEND-JSNA (Joint Strategic Needs Assessment) to support SEND reforms.

The Board noted the update on the occupational therapy service and welcomed the progress shown.

Board Planner and Future Agenda Items

The Board discussed future agenda items, with a focus on the SEND reforms and the place operating model. It was agreed that an update on SEND reforms would be presented in September, with a draft JSNA also to be shared. The complete place operating model was proposed for discussion in December. The deadline for reports for the September meeting was set for 28 August.